Deep vein thrombosis and pulmonary embolism in a patient with acute type B aortic dissection: a case report

Year 2019, , 202 - 205, 04.01.2019

Engin Akgül , Gülen Sezer Alptekin Erkul Sinan Erkul Ahmet Hakan Vural

https://doi.org/10.18621/eurj.403641

Cited By: 1

Abstract

Acute
dissection involving ascending aorta contains high risk of mortality and requires
surgical treatment immediately. Venous thrombosis can manifested as deep vein
thrombosis or pulmonary embolism. It may be isolated or complication of another
disease. Because of pulmonary thromboembolism risk, treatment of deep vein
thrombosis is strongly recommended. A 61-year-old male patient with severe back
pain and shortness of breath presented to the emergency service. The findings
of the physical examinations, chest x-ray and electrocardiogram were normal. Contrast-enhanced
computerized tomography showed an aortic intimal tear that started just below
the subclavian artery and extended into the iliac arteries. The patient was hospitalized
and the medical treatment started. On the 4^th day of clinical
follow-up, pain and swelling started at his right leg with severe shortness of
breath. Venous Doppler ultrasound was performed and there were thrombosis at
popliteal, femoral and even at iliac veins. Computed tomography showed pulmonary
embolism at pulmonary trunk. Aortic dissection treated with endovascular stent
graft firstly to prevent aortic rupture because of anticoagulation and then
pulmonary embolism treated with anticoagulant drugs. Hypercoagulation is a self
defence of the body for limiting the aortic intimal tear to prevent aortic
rupture. So many complications could be seen because of this situation and the
physicians should be awaken for this. 

Keywords

acute aortic dissection, deep vein thrombosis, pulmonary embolism, endovascular stent graft, anticoagulation

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